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https://www.readbyqxmd.com/read/28340233/increase-in-drug-overdose-deaths-involving-fentanyl-rhode-island-january-2012-march-2014
#1
Melissa C Mercado, Steven A Sumner, M Bridget Spelke, Michele K Bohm, David E Sugerman, Christina Stanley
Objective.:  This study identified sociodemographic, substance use, and multiple opioid prescriber and dispenser risk factors among drug overdose decedents in Rhode Island, in response to an increase in overdose deaths (ODs) involving fentanyl. Methods.:  This cross-sectional investigation comprised all ODs reviewed by Rhode Island's Office of the State Medical Examiners (OSME) during January 2012 to March 2014. Data for 536 decedents were abstracted from OSME's charts, death certificates, toxicology reports, and Prescription Monitoring Program (PMP) databases...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340046/validation-of-a-screening-risk-index-for-serious-prescription-opioid-induced-respiratory-depression-or-overdose-in-a-us-commercial-health-plan-claims-database
#2
Barbara K Zedler, William B Saunders, Andrew R Joyce, Catherine C Vick, E Lenn Murrelle
Objective.:  To validate a risk index that estimates the likelihood of overdose or serious opioid-induced respiratory depression (OIRD) among medical users of prescription opioids. Subjects and Methods.:  A case-control analysis of 18,365,497 patients with an opioid prescription from 2009 to 2013 in the IMS PharMetrics Plus commercially insured health plan claims database (CIP). An OIRD event occurred in 7,234 cases. Four controls were selected per case. Validity of the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (RIOSORD), developed previously using Veterans Health Administration (VHA) patient data, was assessed...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28338497/using-selective-serotonin-reuptake-inhibitors-and-serotonin-norepinephrine-reuptake-inhibitors-in-critical-care-a-systematic-review-of-the-evidence-for-benefit-or-harm
#3
John M Kelly, Gordon D Rubenfeld, Neil Masson, Arimie Min, Neill K J Adhikari
OBJECTIVE: Selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitors are among the most commonly prescribed drugs in patients admitted to the ICU. Our objective was to systematically review available literature for evidence of benefit or harm in ICU patients resulting from chronic effects, continued use, or withdrawal. DATA SOURCES: Medline, Embase, and Cochrane Central Register of Controlled Trials (1990 to November 2014). STUDY SELECTION: We searched for studies of ICU patients with recorded selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor prescription before or during admission, and reporting morbidity, mortality, adverse events, and resource measures like ICU length of stay...
March 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28337798/latent-classes-of-polydrug-and-polyroute-use-and-associations-with-human-immunodeficiency-virus-risk-behaviours-and-overdose-among-people-who-inject-drugs-in-tijuana-baja-california-mexico
#4
Meredith C Meacham, Scott C Roesch, Steffanie A Strathdee, Suzanne Lindsay, Patricia Gonzalez-Zuniga, Tommi L Gaines
INTRODUCTION AND AIMS: Patterns of polydrug use among people who inject drugs (PWID) may be differentially associated with overdose and unique human immunodeficiency virus (HIV) risk factors. Subgroups of PWID in Tijuana, Mexico, were identified based on substances used, route of administration, frequency of use and co-injection indicators. DESIGN AND METHODS: Participants were PWID residing in Tijuana age ≥18 years sampled from 2011 to 2012 who reported injecting an illicit substance in the past month (n = 735)...
March 24, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28336158/-acetaminophen-knowledge-use-and-overdose-risk-in-urban-patients-consulting-their-general-practitioner-a-prospective-descriptive-and-transversal-study
#5
Lauriane Cipolat, Ouriel Loeb, Clotilde Latarche, Elise Pape, Pierre Gillet, Nadine Petitpain
INTRODUCTION: Acetaminophen is the most involved active substance in both unintentional and intentional drug poisoning. However, its availability outside community pharmacies is being debated in France. METHODS: We made, via a self-administered questionnaire, a prospective assessment of knowledge, use and acetaminophen overdose risk in patients consulting their general practitioner, in the Metz Métropole urban area, between May 2015 and February 2016. We estimated the prevalence of potential unintentional overdosage by capture-recapture method...
February 20, 2017: Thérapie
https://www.readbyqxmd.com/read/28334840/review-of-caffeine-related-fatalities-along-with-postmortem-blood-concentrations-in-51-poisoning-deaths
#6
Alan Wayne Jones
Publications reporting concentrations of caffeine in postmortem blood were reviewed if the cause of death was attributed to overdosing (poisoning) with drugs. Age and gender of the deceased, the manner of death (accident, suicide or undetermined) and types of co-ingested drugs were evaluated in relation to the concentrations of caffeine in blood (N = 51). The mean age (±SD) of the victims was 39 ± 17.8 years (range 18-84 years) and most were female (N = 31 or 61%). The difference in mean age of males (42 ± 17...
February 18, 2017: Journal of Analytical Toxicology
https://www.readbyqxmd.com/read/28334467/revisiting-the-paradigm-shift-in-opioid-use-developments-and-implications-10%C3%A2-years-later
#7
Benedikt Fischer, Jürgen Rehm
A decade ago, we queried the unfolding of a 'paradigm shift' in illicit opioid use in North America, specifically involving a shift away from heroin to prescription opioid (PO) use. Today, this situation is more acute than ever, with prescription opioid misuse, morbidity and mortality amounting to one of the most severe substance use-related public health crises ever, now even impacting life expectancy in key population segments. Despite medical system-based PO dispensing and practices being recognised as core drivers of the PO crisis, effective policy measures have been long absent or limited-including those to reduce medical PO use to levels supported by best evidence for pain care...
March 23, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28332157/systematic-overdosing-of-oxa-and-cloxacillin-in-severe-infections-treated-in-icu-risk-factors-and-side-effects
#8
Mathilde Neuville, Najoua El-Helali, Eric Magalhaes, Aguila Radjou, Roland Smonig, Jean-François Soubirou, Guillaume Voiriot, Alban Le Monnier, Stéphane Ruckly, Lila Bouadma, Romain Sonneville, Jean-François Timsit, Bruno Mourvillier
BACKGROUND: Oxacillin and cloxacillin are the most frequently used penicillins for the treatment of severe methicillin-susceptible Staphylococcus aureus infections in intensive care units (ICUs), especially endocarditis. International recommendations do not suggest any adaptation of the dosage in case of renal impairment. We wanted to assess the risk factors for overdosing in ICU and the related observed side effects. METHODS: All patients with a therapeutic drug monitoring of oxa- or cloxacillin between 2008 and 2014 were included...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28329723/analysis-of-synthetic-phenethylamine-street-drugs-using-direct-sample-analysis-coupled-to-accurate-mass-time-of-flight-mass-spectrometry
#9
Maura K McGonigal, Joshua A Wilhide, Philip B Smith, Noelle M Elliott, Frank L Dorman
Serious health complications and fatal overdoses have brought phenethylamine, otherwise known as 2C, drug abuse to the public's attention. These compounds are 2C-X series analogs of mescaline. The name "2C" results from the two carbons in the ethyl chain. The substituents on these emerging drugs are constantly changed in order to avoid listing as controlled substances. These synthetic drugs are marketed as having affects similar to LSD and MDMA and are typically consumed sublingually via blotter paper. Twenty-six commercially available standards were analyzed using a direct sample analysis technique coupled to accurate mass time of flight mass spectrometry...
March 8, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28325710/no-evidence-of-compensatory-drug-use-risk-behavior-among-heroin-users-after-receiving-take-home-naloxone
#10
Jermaine D Jones, Aimee Campbell, Verena E Metz, Sandra D Comer
INTRODUCTION: Some fear that distribution of naloxone to persons at risk of experiencing an opioid overdose may reduce the perceived negative consequences of drug use, leading to riskier patterns of use. This study assessed whether participation in naloxone/overdose training altered drug use frequency, quantity or severity among heroin users in and out of treatment. METHODS: Clinical interviews were performed assessing patterns of heroin and other drug use prior to, and at multiple timepoints after overdose education and naloxone training...
March 9, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28324483/the-contribution-of-drug-overdose-to-educational-gradients-in-life-expectancy-in-the-united-states-1992-2011
#11
Jessica Y Ho
Since the mid-1990s, the United States has witnessed a dramatic rise in drug overdose mortality. Educational gradients in life expectancy widened over the same period, and drug overdose likely plays a role in this widening, particularly for non-Hispanic whites. The contemporary drug epidemic is distinctive in terms of its scope, the nature of the substances involved, and its geographic patterning, which influence how it impacts different education groups. I use vital statistics and National Health Interview Survey data to examine the contribution of drug overdose to educational gradients in life expectancy from 1992-2011...
March 21, 2017: Demography
https://www.readbyqxmd.com/read/28323538/relationships-between-a-dissociative-subtype-of-ptsd-and-clinical-characteristics-in-patients-with-substance-use-disorders
#12
Michaela Mergler, Martin Driessen, Ursula Havemann-Reinecke, Dirk Wedekind, Christel Lüdecke, Martin Ohlmeier, Claudia Chodzinski, Sybille Teunißen, Steffen Weirich, Detlef Schläfke, Walter Renner, Ingo Schäfer, Gertrud Koesters, Christian Dette, Olaf Reis, Elisabeth H Sylvester, Martin Hoppe, Markus Stuppe, Thomas Broese, Udo Schneider, Christina Pletke
The increasing support for a dissociative subtype of post-traumatic stress disorder (PTSD-D) has led to its inclusion in DSM-5. We examined relationships between PTSD-D and relevant variables in patients with substance use disorders (SUD). The sample comprised N = 459 patients with SUD. The International Diagnostic Checklist and the Posttraumatic Diagnostic Scale were used to diagnose PTSD. In addition, participants completed the Childhood Trauma Questionnaire and the Dissociative Experiences Scale. The course of SUD was assessed by means of the European Addiction Severity Index...
March 21, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28323507/heroin-and-methamphetamine-injection-an-emerging-drug-use-pattern
#13
Alia Al-Tayyib, Stephen Koester, Sig Langegger, Lisa Raville
OBJECTIVE: We sought to describe an emerging drug use pattern characterized by injection of both methamphetamine and heroin. We examined differences in drug injection patterns by demographics, injection behaviors, HIV and HCV status, and overdose. METHODS: Persons who inject drugs (PWID) were recruited as part of the National HIV Behavioral Surveillance (NHBS) system in Denver, Colorado. We used chi-square statistics to assess differences between those who reported only heroin injection, only methamphetamine injection, and combined heroin and methamphetamine injection...
March 21, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28320983/levetiracetam-and-topiramate-poisoning-two-overdoses-on-those-drugs-with-no-lasting-effects
#14
Moaziz Sarfaraz, Rana Hasan Syeda
Levetiracetam and topiramate are newer anticonvulsants, which is why international data on overdoses of these drugs are lacking. Only a few mild adverse reactions have been noted. These anticonvulsants have been the drug of choice for neurologists. Despite their wide usage, there is a dearth of literature on symptoms and signs of their toxicity. Presented here is the case of a 21-year-old female who overdosed twice on levetiracetam and topiramate. The woman was admitted and discharged after the first overdose...
March 19, 2017: Drug Discoveries & Therapeutics
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#15
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319291/high-risk-of-overdose-death-following-release-from-prison-variations-in-mortality-during-a-15-year-observation-period
#16
Anne Bukten, Marianne Riksheim Stavseth, Svetlana Skurtveit, Aage Tverdal, John Strang, Thomas Clausen
BACKGROUND AND AIMS: The time post-release from prison involves elevated mortality, especially overdose deaths. Variations in overdose mortality both by time since release from prison and time of release has not been sufficiently investigated. Our aims were to estimate and compare overdose death rates at time intervals after prison release and to estimate the effect on overdose death rates over calendar time. DESIGN, SETTING, PARTICIPANTS, MEASUREMENTS: This 15-year cohort study includes all persons (n= 91,090) released from prison (01...
March 20, 2017: Addiction
https://www.readbyqxmd.com/read/28315808/benzodiazepine-z-drug-and-pregabalin-prescriptions-and-mortality-among-patients-in-opioid-maintenance-treatment-a-nation-wide-register-based-open-cohort-study
#17
Tove Abrahamsson, Jonas Berge, Agneta Öjehagen, Anders Håkansson
BACKGROUND: Use of sedatives may increase risk of death in opioid users. The aim of the study was to assess whether prescription of sedatives may be associated with mortality in patients in opioid maintenance treatment. METHODS: This retrospective register-based open cohort study included nation-wide register data including all individuals who were dispensed methadone or buprenorphine as opioid maintenance treatment for opioid dependence between July, 2005 and December, 2012 (N=4501)...
February 28, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28315595/the-social-logic-of-naloxone-peer-administration-harm-reduction-and-the-transformation-of-social-policy
#18
Rachel Faulkner-Gurstein
This paper examines overdose prevention programs based on peer administration of the opioid antagonist naloxone. The data for this study consist of 40 interviews and participant observation of 10 overdose prevention training sessions at harm reduction agencies in the Bronx, New York, conducted between 2010 and 2012. This paper contends that the social logic of peer administration is as central to the success of overdose prevention as is naloxone's pharmacological potency. Whereas prohibitionist drug policies seek to isolate drug users from the spaces and cultures of drug use, harm reduction strategies like peer-administered naloxone treat the social contexts of drug use as crucial resources for intervention...
March 9, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28306366/serum-osmolal-gap-in-clinical-practice-usefulness-and-limitations
#19
George Liamis, Theodosios D Filippatos, Angelos Liontos, Moses S Elisaf
BACKGROUND: Although serum osmolal gap can be a useful diagnostic tool, clinicians are not familiar with its use in clinical practice. OBJECTIVES: The review presents in a series of questions-answers and under a clinical point of view the current data regarding the use of osmolal gap. DISCUSSION: The definition and the best formula used for the calculation of osmolal gap, the main causes of increased osmolal gap with or without increased anion gap metabolic acidosis, as well as the role of concurrent lactic acidosis or ketoacidosis are presented under a clinical point of view...
March 23, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28299558/body-pushing-prescription-drugs-and-hospital-admission
#20
Roger W Byard, Michaela Kenneally
A 39-year-old man died of multi-organ failure complicating mixed drug toxicity that included methadone, oxazepam, oxycodone and nitrazepam. His past medical history involved alcohol and poly-substance abuse with chronic self-harm and suicidal ideation. There had been multiple hospital admissions for drug overdoses. At autopsy the most unusual finding was of two packages of 10 tablets each, wrapped in thin plastic film within the rectum. The insertion of drugs into body orifices and cavities has been termed body pushing to distinguish it from body packing where illicit drugs are wrapped and swallowed for transport and smuggling, and body stuffing where small amounts of loosely wrapped or unwrapped drugs are swallowed to conceal evidence from police...
March 15, 2017: Forensic Science, Medicine, and Pathology
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